NPI | 1285257816 |
---|---|
Entity Type | Organization |
Authorized Contact | EBONY WILLIS Coordinator 803-497-4303 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2020-05-18 |
Last Update Date | 2020-05-18 |